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TRAINING COURSE FOR MASTER TRAINERS IN BREAST, CERVICAL, COLORECTAL AND

ORAL CANCER EARLY DETECTION AND CONTROL

Jointly organised by
The National Cancer Control Programme, Ministry of Health and Indigenous Medicine,
Colombo, Sri Lanka
The International Agency for Research on Cancer, World Health Organization
(IARC/WHO), Lyon, France;
The WHO Country Office, Colombo, Sri Lanka

PROGRAMME
26 29 May 2015

Training course location:


Hector Kobbekaduwa Agrarian Research and Training Institute 114, Wijerama Mawatha,
Colombo 07, Sri Lanka.: +94-11-2698539-41 / +94-11-7417100-5
Web site : http://www.harti.gov.lk/
Cervical & Breast Cancer Early detection and control for MO/MCHs
26-27 May 2015 - Narayanasamy Conference Hall
Cervical, Breast, Colorectal and Oral Cancer Early detection and control for MO/NCDs
28-29 May 2015 - Narayanasamy Conference Hall
Oral Cancer Early detection and control for Regional Dental Surgeons
29 May 2015 - Subasinghe Conference Hall
With generous support from
A GETI Fellowship from the International Union Against Cancer (UICC)

NATIONAL FACULTY
Dr Kanishka Karunaratne
Consultant Gyneoncologist, NCI Maharagama
nlkgkaru@yahoo.com
Dr Samanthi Premaratne
Consultant Gyneoncologist, NCI Maharagama
samanthipremaratne@gmail.com
Dr Himali Ihalagama
Consultant Gyneoncologist, NCI Maharagama
himaliihalagama@yahoo.com
Dr Kanishka De Silva
Consultant Oncosurgeon, NCI Maharagama
gksdesilva@gmail.com
Dr Ajith De Silva
Consultant General Surgeon, NHSL
adesilva60@yahoo.com
Dr Yasantha Ariyaratne
Consultant Oncologist, NCI Maharagama
yariyaratne@yahoo.com
Dr B.G.N. Rathnasena
Consultant General Surgeon, NHSL
nimalrsena@gmail.com
Dr Ranil Jayasena
Consultant GI Surgeon, NHSL
rjayasena@gmail.com
Dr N.M.M. Navarathne
Consultant GI Physician, NHSL
nmmnawarathne@gmail.com

Dr Hemantha Amarasinghe
Cancer Epidemiologist & Board Certified Consultant in Dental Public Health
Research and Surveillance Unit, Institute of Oral Health
hemanthaamarasinghe@yahoo.com

Prof W.M. Thilakaratne


Professor of Oral Pathology,
Faculty of Dental Sciences, University of Peradeniya
wmtilak@pdn.ac.lk
Dr Padma De Silva
Consultant OMF Surgeon, DI Colombo
spadmasilva@gmail.com
Dr D.K. Dias
Consultant OMF Surgeon, TH Karapitiya
dkdias@sltnet.lk
Dr Janakie Fernando
Consultant Histopathologist of National Hospital
janakifernando@gmail.com
Dr Pandula Hettiarachchi
Consultant Radiologist of National Hospital
pandula69@icloud.com
Dr Prasanna Jayasekara
Consultant in Community Dentistry
National Cancer Control Programme,
Ministry of Health and Indigenous Medicine
jayasekara_prasanna@yahoo.com
Dr Nayana De Alwis
Consultant Community Physician
National Cancer Control Programme,

Ministry of Health and Indigenous Medicine


dealwisnayana@gmail.com
Dr Nethanjalie Mapitigama
Programme Manager Women Health
Family Health Bureau, Ministry of Health and Indigenous Medicine
nethmap@hotmail.com
Dr Ramani Punchihewa
Consultant Pathologist
District General Hospital - Kalutara
ramanipunchihewa@yahoo.com

INTERNATIONAL FACULTY
Dr Rengaswamy Sankaranarayanan, Course Director
Special Advisor on Cancer Control
The International Agency for Research on Cancer (IARC/WHO), Lyon, France
Dr Walter Prendiville
Senior Visiting Scientist
The International Agency for Research on Cancer (IARC/WHO), Lyon, France
Dr Babu Mathew
Professor of Community Oncology, Regional Cancer Centre
Trivandrum, India
Dr Ashrafun Nessa
Professor, Department of Obstetrics & Gynaecology, BSMMU
Dhaka, Bangladesh
Dr Aylor S. Ramakrishnan
Additional Professor (GI & HPB oncology), Surgical Oncologist
Cancer Institute (WIA), Chennai, India

LOCAL ORGANIZERS

Dr Eshani Fernando, Director


Dr Nayana De Alwis, Consultant Community Physician
Dr Prasanna Jayasekara, Consultant in Community Dentistry
National Cancer Control Programme, Ministry of Health and Indigenous Medicine,
Colombo, Sri Lanka
Dr Suraj Perera, Consultant Community Physician, Course Co-Director
National Cancer Control Programme, Ministry of Health and Indigenous Medicine,
Colombo, Sri Lanka

COURSE SECRETARIAT:
Ms Sandrine Montigny, Screening Group
The International Agency for Research on Cancer (IARC/WHO), Lyon, France
montignys@iarc.fr

Tuesday 26 May 2015 (for MO/MCHs day 1 of 2)


Narayanasamy Conference Hall
09.00 09.10

Welcome and Opening Ceremony

09.10 - 09.20

Presentation of workshop objectives,


expected results and outcomes

09.20 09.35

Pre-workshop evaluation questionnaire

09.35 10.00

Introductions (participants and faculty)

Dr Eshani and Sri Lankan colleagues


Dr Eshani/Dr R. Sankar

Cervical Cancer Early detection and control


10.00 10.15

Cervical cancer: causes, global burden and prevention using

Dr R.

Sankar

HPV vaccination
10.15 - 10.30

Coffee break

10.45 11.00

Anatomy and physiology of lower genital


tract with particular emphasis on the cervix
Natural history and pathology of cervical neoplasia
Screening for cervical cancer: cytology, HPV testing,

11.15 11.30
11.30 12.00

Premaratne

Dr H. Ihalagama
Dr R. Sankar
Dr S.

Visual screening
12.00 12.15

Current situation in Cervical Cancer Screening

Dr N. Mapitigama

Programme in Sri Lanka and way forward


12.15 - 12.25

Cervical Cytology & Reporting in cervical cancer


screening programme in Sri Lanka
Introduction to colposcopy: Colposcopic features of

12.25 13.10

Dr R. Punchihewa
Dr W. Prendiville

normal cervix, inflammation, CIN and preclinical


early invasive cancer; role of colposcopy in the early
detection and prevention of cervical neoplasia
13.10 - 14.00

Lunch

14.00 14.30

Treatment of precancerous lesions using


thermocoagulation (cold coagulation) and cyotherapy
Treatment of precancerous lesions using LLETZ

14.30 15.15

Dr A. Nessa
Dr W. Prendiville

and cold knife conization


15.15 - 15.45

Staging and surgical management of cervical cancer

15.45 16.00

Coffee break

16.00- 16.20
16.20 16.50

Non-surgical management of cervical cancer


Bangladesh national cervical screening programme

16.50 17.20

Screening for cervical cancer:

Dr K. Karunaratne

Dr R. Sankar
Dr A. Nessa

Dr Eshani and Sri Lankan colleagues

Strategies and recommendations,


National Guidelines, discussion and questions

Wednesday 27 May 2015 (for MO/MCHs day 2 of 2)


Narayanasamy Conference Hall
Breast Cancer Early detection and control
09.00 09.30

Global burden risk factors and prevention breast cancer

09.30 10.00
10.00 - 10.25
10.25 10.50
10.50 11.00

Anatomy of the breast, symptoms


Dr Ajith De Silva
signs and staging of breast cancer
Breast awareness, breast self- examination
Dr R. Sankar
Screening and early diagnosis by clinical breast examination
Dr A. Nessa
Strengthening early detection of breast cancers
Dr N. de Alwis

11.00 11.30

Coffee break

11.30 12.00

Mammography and ultrasonography in screening

Dr R.

Sankar

Dr P. Hettiarachchi

12.00 12.30

and early diagnosis of breast cancer


The role of cytology and histopathology
including immuno-histochemistry in the early diagnosis

Dr J. Fernando

and management of breast cancer


12.30 13.30

Lunch break

13.30 14.00

Treatment of breast cancer: surgery

14.00 14.30

Treatment of breast cancer: radiotherapy

Dr Y. Ariyaratne

14.30 15.00

Treatment of breast cancer: adjuvant chemo

Dr Y. Ariyaratne

Dr Kanishka De Silva

and hormone therapy


15.00 15.30

Coffee break

15.30 16.00

Practical sessions on clinical breast examination and diagnosis of breast


cancer: using breast prosthesis.

16.00 16.30

General discussion: Breast cancer

Dr Eshani & Sri Lankan

colleagues

early detection approaches in primary care


and breast cancer control policy in Sri Lanka
16.30 17.00

Post-workshop evaluation questionnaire

17.00 17.30

Distribution of certificates, Closing ceremony

Thursday 28 May 2015 (for MO/NCDs day 1 of 2)


Narayanasamy Conference Hall

08.00 08.15

Welcome and Opening Ceremony

Dr Eshani and Sri Lankan colleagues

Presentation of workshop objectives,


expected results and outcomes
08.15 08.30

Pre-workshop evaluation questionnaire

08.30 08.45

Introductions (participants and faculty)

Dr R. Sankar

Cervical and Breast Cancer Early detection and control

09.00 - 09.45
09.45 10.15

Anatomy and physiology of the lower genital tract, natural history of


cervical cancer, screening methods for cervical neoplasia
Dr R. Sankar
Introduction to the role of colposcopy in the prevention of
Dr R. Sankar
cervical cancer

10.15 10.45

Treatment of precancerous lesions by cold coagulation


and cyotherapy

10.45 - 11.00

Coffee break

11.00 11.20

Treatment of precancerous lesions by LLETZ and

Dr A. Nessa

Dr K.

Karunaratne

cold knife conization


11.20 11.50

Staging and surgical management of cervical cancer

11.50 - 12.10
12.10 - 12.30

Non-surgical treatment of cervical cancer


Prevention of cervical cancer by HPV vaccination

12.30 13.00

Prevention & screening of cervical cancer:

Dr K. Karunaratne
Dr R. Sankar
Dr A. Nessa

Dr Eshani & Sri Lankan

colleagues

Strategies and recommendations,


National Guidelines, discussion and questions
13.00 - 14.00

Lunch break

14.00 14.30

14.50 - 15.10

Anatomy of the breast, symptoms, signs and staging


Dr Ajith Da Silva
of breast cancer
Breast awareness, breast self- examination, and clinical
Dr A. Nessa
breast examination in the early diagnosis of breast cancer
Mammography and ultrasonography in the early
Dr P.

15.10 - 15.30

diagnosis and management of breast cancer


Fine needle aspiration cytology and histopathology

15.30 15.45

Coffee break

15.45 16.05

Treatment of breast cancer: surgery

16.05 16.30

Treatment of breast cancer: radiotherapy,

14.30 - 14.50

Hettiarachchi

Dr J. Fernando

Dr Kanishka Da Silva
Dr Y. Ariyaratne

chemotherapy and hormone therapy


16.30 16.45

Practical sessions on clinical breast examination


and diagnosis of breast cancer: using breast prosthesis.

16.45 17.00

General discussion: Breast cancer

Dr Eshani & Sri Lankan

colleagues

early detection approaches in primary care


and breast cancer control policy in Sri Lanka

Friday 29 May 2015 (for MO/NCDs day 2 of 2)


Narayanasamy Conference Hall
Colorectal and Oral Cancer Early detection and control
09.00 - 09.30

Anatomy of the large bowel, natural history


Dr B.G.N. Rathnasena
of colorectal cancer: adenoma-carcinoma sequence,
neoplastic and non-neoplastic lesions of the colorectal mucosa

09.30 09.45

Colorectal cancer screening using fecal occult blood


testing (FoBT)

09.45 10.15

Staging and treatment of colorectal cancer

10.15 10.45

The role of colonoscopy in the early detection of colorectal Dr R. Jayasena


cancer

10.45 - 11.15

Treatment of lesions during colonoscopy:

Dr R. Sankar
Dr A.S. Ramakrishnan

Dr N.M.M. Navarathne

polypectomy, endoscopic mucosal resection,


endoscopic submucosal dissection
11.15 - 11.30
11.30 12.00

Coffee break
Demonstration of the FoBT kit with faecal samples,
demonstration of colonoscopy and endoscopic excision
procedures using videos

12.00 -12.30

General discussion: Integrating colorectal

Dr Eshani & Sri Lankan

colleagues

cancer early detection and referral in primary care


12.30 - 13.30

Lunch break

14.00 14.30

Anatomy of the oral cavity and oral visual and soft


Dr B. Mathew
tissue examination methods and documenting findings
Natural history of oral carcinogenesis:
Dr W.M. Thilakaratne
oral precancerous lesions
Screening and early diagnosis of oral precancerous
Dr B. Mathew
lesions and oral cancer using oral visual screening

14.30 15.00
15.00 15.30
15.30 15.45

Coffee break

15.45
16.00
16.30
17.00

Management of oral precancerous lesions


Dr Padma Da Silva
Staging and surgical management of oral cancer
Dr D.K. Dias
Non-surgical management of oral cancer
Dr R. Sankar
Screening for oral cancer: Strategies
Dr Eshani & Sri Lankan colleagues

- 16.00
16.30
17.00
- 17.30

17.30 17.45
17.45 18.15

and recommendations, National Guidelines,


discussion and questions
Post-workshop evaluation questionnaire
Distribution of certificates, Closing ceremony

Friday 29 May 2015 (for Regional Dental Surgeons)


Subasinghe Conference Hall
Oral Cancer Early detection and control
08.00 08.15

Welcome and Opening Ceremony

Dr Eshani and Sri Lankan colleagues

08.15 - 08.30

Presentation of workshop objectives,


expected results and outcomes

08.30 08.45

Pre-workshop evaluation questionnaire

08.45 09.00

Introductions (participants and faculty)

09.00 09.30
09.30 10.00

Global burden of and risk factors for oral cancer


Dr H. Amarasinghe
Anatomy of the oral cavity and oral visual and soft
Dr B. Mathew
tissue examination methods and documenting findings
Natural history of oral carcinogenesis:
Dr W.M. Thilakaratne
oral precancerous lesions
Screening and early diagnosis of oral cancer
Dr B. Mathew
using oral visual screening

10.00 10.30
10.30 11.00
11.00 11.15

Coffee break

11.15 11.30

Adjunctive tests for early detection

11.30 - 12.00
12.00 - 12.30
12.30 - 13.00

of oral neoplasia
Management of oral precancerous lesions
Staging and management of oral cancer
Non-surgical management of oral cancer

13.00 14.00

Lunch break

14.00 - 14.30

16.00 16.30

Screening for oral cancer: Strategies


and recommendations, National Guidelines,
discussion and questions
Practical sessions using videos/photos of
oral precancerous and cancer lesions
General discussion

16.30 17.00

Post-workshop evaluation questionnaire

17.00 - 17.15

Distribution of certificates, Closing ceremony

14.30 16.00

Dr R. Sankar

Dr W.M.

Thilakaratne

Dr Padma Da Silva
Dr D.K. Dias
Dr R. Sankar

Dr P. Jayasekera

Workshop documents will be accessible to participants:

Sri Lanka NCCP documents and early detection guidelines for cervix, breast and oral
cancers
Colposcopy and Treatment of Cervical Intraepithelial Neoplasia: A Beginners Manual

Manuals on the role of cold coagulation and cryotherapy in the treatment of cervical
intraepithelial neoplasia (CIN) lesions
E-publication book chapter Treatment of precancerous cervical lesions
Training materiel on VIA, VILI, LEEP, cryotherapy and cold coagulation and other
electronic documents in PDF).
Breast, oral and cervix cancer early detection charts
IARC Manual on early detection of breast cancer
IARC Manual on early detection of oral neoplasia
IARC manual on colonoscopy and early detection of colorectal cancer
Selected literature on breast, cervix, colorectal and oral cancer early detection and
treatment
WHO Guidance note on cervical cancer control
WHO position paper on HPV screening
WHO guidelines on mammographic screening
IARC Publications (Sankar et al in Cancer Control by INCTR) on cervix, breast and
colorectal cancer early detection in primary care